Inspection on 03/06/08 for White Lodge Residential Home

This inspection was carried out on 3rd June 2008.

CSCI found this care home to be providing an Good service.

The inspector made no statutory requirements on the home as a result of this inspection and there were no outstanding actions from the previous inspection report.

Other inspections for this house

White Lodge Residential Home 01/02/10

White Lodge Residential Home 09/06/09

White Lodge Residential Home 25/04/07

White Lodge Residential Home 29/11/06

Similar services:

Maple Lodge

Heathlands

Aston Court Nursing Home

Breme

Ravenhurst

Bank House

Inspirations

Westmead

Extracts from inspection reports are licensed from CQC, this page was updated on 28/09/2008.

CARE HOMES FOR OLDER PEOPLE White Lodge Residential Home White Lodge Fenn Green Alveley Nr Bridgnorth Shropshire WV15 6JA Lead Inspector Pat Scott Key Unannounced Inspection 10:00 3rd June 2008 X10015.doc Version 1.40 Page 1 The Commission for Social Care Inspection aims to: • • • • Put the people who use social care first Improve services and stamp out bad practice Be an expert voice on social care Practise what we preach in our own organisation Reader Information Document Purpose Author Audience Further copies from Copyright Inspection Report CSCI General Public 0870 240 7535 (telephone order line) This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI www.csci.org.uk Internet address White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 2 This is a report of an inspection to assess whether services are meeting the needs of people who use them. The legal basis for conducting inspections is the Care Standards Act 2000 and the relevant National Minimum Standards for this establishment are those for Care Homes for Older People. They can be found at www.dh.gov.uk or obtained from The Stationery Office (TSO) PO Box 29, St Crispins, Duke Street, Norwich, NR3 1GN. Tel: 0870 600 5522. Online ordering: www.tso.co.uk/bookshop This report is a public document. Extracts may not be used or reproduced without the prior permission of the Commission for Social Care Inspection. White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 3 SERVICE INFORMATION Name of service White Lodge Residential Home Address White Lodge Fenn Green Alveley Nr Bridgnorth Shropshire WV15 6JA 01299 861120 01299 862038 white-lodge@hotmail.co.uk Telephone number Fax number Email address Provider Web address Name of registered provider(s)/company (if applicable) Name of registered manager (if applicable) Type of registration No. of places registered (if applicable) Oldfield Residential Care Limited Manager post vacant Care Home 36 Category(ies) of Dementia - over 65 years of age (15), Old age, registration, with number not falling within any other category (21) of places White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 4 SERVICE INFORMATION Conditions of registration: 1. Maximum number of Service Users is 36 (Thirty Six). Date of last inspection 25th April 2007 Brief Description of the Service: White Lodge is a large adapted building currently providing personal care and accommodation for up to 36 older people. The home is located in a rural position on the A 442 between Bridgnorth and Kidderminster offering both single and double bedroom accommodation. The front door to this home is kept locked with a number of keypad entries to internal doors around the home. The home is owned by Oldfield Care Ltd with White Lodge being one of a number of care homes within this company. Weekly fees range from £380.00 - £ 450.00. Information about the home and the provision of the service are available in the statement of purpose and service user guide. White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 5 SUMMARY This is an overview of what the inspector found during the inspection. The quality rating for this service is *two star good service. This means the people who use this service experience good quality outcomes. We, the commission, used a range of evidence to make judgements about this service. This includes: information from the management in the annual quality assurance assessment (AQAA), staff records kept in the home, medication records, discussion with people who use the service, discussion with the acting manager, tour of the premises, previous inspection reports, quality assurance processes, Fire Authority reports, Environmental Health Office reports, observation of care experienced by people using the service. What the service does well: What has improved since the last inspection? The service information content and availability has improved. The service has identified where the quality of this can improve further i.e. to make the statement of purpose more reader friendly, the addition of pictures and alternative formats. Assessment records for new admissions are more organised. Through planned service reviews gaps can be identified and action plans provided to address any shortfalls. Care plan organisation is improving. A new clear format is in the process of being implemented. White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 6 Management systems in place are more consistently used to safeguard service users such as, risk assessments, quality assurance surveys, audits and care plan reviews. There has been an improved approach to service user consultation and taking into account their views. What they could do better: Please contact the provider for advice of actions taken in response to this inspection. The report of this inspection is available from enquiries@csci.gsi.gov.uk or by contacting your local CSCI office. The summary of this inspection report can be made available in other formats on request. White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 7 DETAILS OF INSPECTOR FINDINGS CONTENTS Choice of Home (Standards 1–6) Health and Personal Care (Standards 7-11) Daily Life and Social Activities (Standards 12-15) Complaints and Protection (Standards 16-18) Environment (Standards 19-26) Staffing (Standards 27-30) Management and Administration (Standards 31-38) Scoring of Outcomes Statutory Requirements Identified During the Inspection White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 8 Choice of Home The intended outcomes for Standards 1 – 6 are: 1. 2. 3. 4. 5. 6. Prospective service users have the information they need to make an informed choice about where to live. Each service user has a written contract/ statement of terms and conditions with the home. No service user moves into the home without having had his/her needs assessed and been assured that these will be met. Service users and their representatives know that the home they enter will meet their needs. Prospective service users and their relatives and friends have an opportunity to visit and assess the quality, facilities and suitability of the home. Service users assessed and referred solely for intermediate care are helped to maximise their independence and return home. The Commission considers Standards 3 and 6 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standard 3 National Minimum Standard 1 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People can be confident that the care home can support them. This is because there is a complete assessment of their needs that they, or people close to them, have been involved in. People will be able to feel that they can live the life they choose in the home. This is because the assessment is person centred and shows an understanding and respect for their diversity. Prospective residents and their representatives are provided with information needed to assist them to choose a home which will meet their needs. EVIDENCE: The service has developed a statement of purpose, which sets out the aims and objectives of the home and includes a service user guide, which provides information about the service that the care home offers. White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 9 Admission assessments read of three recently admitted people show the service is taking into account the individual physical care needs of a service user in a person centred way. The acting manager states she consults the assessment information to see if the home can meet the prospective person’s needs before they make the decision to accept the application for admission and offer a placement. White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 10 Health and Personal Care The intended outcomes for Standards 7 – 11 are: 7. 8. 9. 10. 11. The service user’s health, personal and social care needs are set out in an individual plan of care. Service users’ health care needs are fully met. Service users, where appropriate, are responsible for their own medication, and are protected by the home’s policies and procedures for dealing with medicines. Service users feel they are treated with respect and their right to privacy is upheld. Service users are assured that at the time of their death, staff will treat them and their family with care, sensitivity and respect. The Commission considers Standards 7, 8, 9 and 10 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 7,8,9,10 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. People receive personal support from staff, to be as well as they can be, in a way they prefer and want so that their physical and emotional needs are met. People who can manage their own medicine are able to do so as the service can support them with it in a safe way. The acting manager understands the need to comply with safe medication systems and has improved these so that residents’ health matters are safely addressed. EVIDENCE: New care plans are being developed, the records of which give some indication of consultation with the individual concerned or their supporter. People who have been in the home some time are having their care plans brought up to date in this new format. There is a record of regular review. Assessments for risk such as pressure areas, falls, nutrition and manual handling have been White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 11 completed. The manager agreed more work is needed to transfer all identified needs into plans of care and to record weights. No issues were identified in discussions with people regarding approach of staff or being assisted with intimate tasks. A comment within compliment letters includes: ‘ we appreciate all the caring you showed our mother, we will all miss your smiling faces.’ Medication systems follow good practice. The current practice and robust recording safeguard people who use the service from the risk of misuse and mishandling of medication. The manager intends to conduct medication audits to ensure compliance with the administration, safekeeping and disposal of all drugs. It is made clear what is required in their professional performance through the supervision process and keyworker roles. White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 12 Daily Life and Social Activities The intended outcomes for Standards 12 - 15 are: 12. 13. 14. 15. Service users find the lifestyle experienced in the home matches their expectations and preferences, and satisfies their social, cultural, religious and recreational interests and needs. Service users maintain contact with family/ friends/ representatives and the local community as they wish. Service users are helped to exercise choice and control over their lives. Service users receive a wholesome appealing balanced diet in pleasing surroundings at times convenient to them. The Commission considers all of the above key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 12,13,14,15 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Residents are provided with social activity and can keep in contact with family and friends. Social, cultural and recreational activities meet resident’s expectations through assessment, consultation and choice. Residents receive a healthy diet according to their assessed requirement and preference. EVIDENCE: Staff are aware of individual needs and preferences and organise activities to suit. Staff responded promptly to individual requests and have made changes to the environment to support people to be as independent as possible. Daily routines are recorded in care plans which have a section relating to the personal/social history of the resident which provides information to staff to use to discuss with the resident. A list of activities for the week are on display. The manager is planning to organise more outings for the summer and increase the provision of reminiscence activity and stimulation therapy. The service does not have a coWhite Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 13 ordinator for leisure pursuits at present but the manager is actively recruiting one. Multi-denomination services are held regularly. A group of residents were knitting items for charity. People are complimentary about the provision of meals. Menus are displayed around the home. Nutritional risk assessments are conducted and needs identified are acted upon. White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 14 Complaints and Protection The intended outcomes for Standards 16 - 18 are: 16. 17. 18. Service users and their relatives and friends are confident that their complaints will be listened to, taken seriously and acted upon. Service users’ legal rights are protected. Service users are protected from abuse. The Commission considers Standards 16 and 18 the key standards to be. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 16,18 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The service has a complaints procedure that is up to date and accessible so that anyone associated with the service can complain or make suggestions for improvement. EVIDENCE: The service has a complaints procedure that meets the national minimum standards and regulations. The complaints procedure is visible within the home and is contained in the service user guide. The service has not received any direct complaints since the last inspection. The acting manager is clear when incidents need external input and who to refer the incident to. Links with external agencies are satisfactory and include the commission, police and adult protection teams. People who use the service state they are satisfied with the service provision, and feel safe and supported. They say that they would go to the staff in charge if they had a problem. The home has received a number of complimentary cards/letters which praise the care staff provide. Staff are provided with regular updates in adult protection. White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 15 Environment The intended outcomes for Standards 19 – 26 are: 19. 20. 21. 22. 23. 24. 25. 26. Service users live in a safe, well-maintained environment. Service users have access to safe and comfortable indoor and outdoor communal facilities. Service users have sufficient and suitable lavatories and washing facilities. Service users have the specialist equipment they require to maximise their independence. Service users’ own rooms suit their needs. Service users live in safe, comfortable bedrooms with their own possessions around them. Service users live in safe, comfortable surroundings. The home is clean, pleasant and hygienic. The Commission considers Standards 19 and 26 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 19,26 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The physical design and layout of the home enables service users to live in a safe, well-maintained and comfortable environment, which encourages independence. EVIDENCE: Areas seen around the home are clean and rooms personalised according to taste. Call bell systems are working and are within reach of service users. People spoken with said they are happy with their room. The laundry is well organised with systems in place to deal with soiled linen. Hand washing facilities are available in all areas used by staff. White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 16 Staffing The intended outcomes for Standards 27 – 30 are: 27. 28. 29. 30. Service users’ needs are met by the numbers and skill mix of staff. Service users are in safe hands at all times. Service users are supported and protected by the home’s recruitment policy and practices. Staff are trained and competent to do their jobs. The Commission consider all the above are key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 27,28,29,30 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. Staff get access to training, supervision and support they need from the manager so that people receive good care. EVIDENCE: There are experienced staff employed to provide care to people at the home, and staff who have gained national vocational qualifications (NVQ). The acting manager recognises the importance of training, and is trying to organise a programme that will meet mandatory requirements for 2008. the keyworker and coworker system has been introduced. A resident spoken with could name her keyworker. Care plans show that there is understanding of the person centred way of delivering care and support which the manager reported will be reinforced through training. People using the service tell us that staff working with them provide safe and appropriate support. Three staff personnel files were selected for inspection, all the necessary checks had been carried out but with some discrepancy in start dates and criminal record check and reference returns. The acting manager stated that all White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 17 recruitment activity since she has been in post now follows the requirements of the regulations. She stated no person will be confirmed in post until all checks have been returned satisfactory. The acting manager reported that there had been some staffing issues, some of which had been relayed to the commission via anonymous sources. She stated that the new recruitment will resolve these problems. She organises staff rotas to show that the numbers and skills of staff meet the needs of people accommodated. Specific training for dementia care is being arranged including the management of actual or potential aggression. White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 18 Management and Administration The intended outcomes for Standards 31 – 38 are: 31. 32. 33. 34. 35. 36. 37. 38. Service users live in a home which is run and managed by a person who is fit to be in charge, of good character and able to discharge his or her responsibilities fully. Service users benefit from the ethos, leadership and management approach of the home. The home is run in the best interests of service users. Service users are safeguarded by the accounting and financial procedures of the home. Service users’ financial interests are safeguarded. Staff are appropriately supervised. Service users’ rights and best interests are safeguarded by the home’s record keeping, policies and procedures. The health, safety and welfare of service users and staff are promoted and protected. The Commission considers Standards 31, 33, 35 and 38 the key standards to be inspected. JUDGEMENT – we looked at outcomes for the following standard(s): Key Standards 31,33,35,38 Quality in this outcome area is good. This judgement has been made using available evidence including a visit to this service. The management of the home is based on openness and respect. The service has quality assurance surveys in place so that people are assured that the overall conduct of the home is taking into account their views. People’s opinions are more central to how the home develops and reviews it’s practice, and the service is developing appropriate ways of making sure they get things right. So, people have confidence in the care home because it is run and managed better. EVIDENCE: The notice board outside the home refers to the previous manager which is misleading for potential customers. The service does not currently have a White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 19 manager, registered with the commission, in post. The deputy manager is ‘acting up’ on a secondment basis and has been in post for only three weeks. The acting manager has management experience and some knowledge of the National Minimum Standards and regulatory framework within which she must operate. From records seen the care home provider visits the home, the last visit recorded being February 2008. The provider is required to do this at least monthly to evidence the monitoring of the running of the home. Through discussion, the acting manager is aware of the need to plan the business activity of the home. The acting manager is improving and developing systems that monitor practice and compliance with the plans, policies and procedures of the home The acting manager was open in her wishes and ideas for improvement to the service. There are formal audits to check whether policies and procedures are being adhered to and that systems are working to achieve good outcomes for service users on an on going basis. The manager acknowledged the need to use these more robustly. Plans for improvement are to be implemented by the acting manager with no administrative support. The acting manager understands person centred planning and thinking. Quality assurance takes place with collated results from surveys to demonstrate how service users and their supporters are consulted about life in the home. Service users confirmed they are being asked their point of view. The acting manager arranges for staff to have mandatory training consistently and equally so that they are knowledgeable to care for people who use the service. White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 20 SCORING OF OUTCOMES This page summarises the assessment of the extent to which the National Minimum Standards for Care Homes for Older People have been met and uses the following scale. The scale ranges from: 4 Standard Exceeded 2 Standard Almost Met (Commendable) (Minor Shortfalls) 3 Standard Met 1 Standard Not Met (No Shortfalls) (Major Shortfalls) “X” in the standard met box denotes standard not assessed on this occasion “N/A” in the standard met box denotes standard not applicable CHOICE OF HOME Standard No Score 1 2 3 4 5 6 ENVIRONMENT Standard No Score 19 20 21 22 23 24 25 26 3 X 3 X X N/A HEALTH AND PERSONAL CARE Standard No Score 7 3 8 3 9 3 10 3 11 X DAILY LIFE AND SOCIAL ACTIVITIES Standard No Score 12 3 13 3 14 3 15 3 COMPLAINTS AND PROTECTION Standard No Score 16 3 17 X 18 3 3 X X X X X X 3 STAFFING Standard No Score 27 3 28 3 29 3 30 3 MANAGEMENT AND ADMINISTRATION Standard No 31 32 33 34 35 36 37 38 Score 2 X 3 X 3 X X 3 White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 21 Are there any outstanding requirements from the last inspection? No STATUTORY REQUIREMENTS This section sets out the actions, which must be taken so that the registered person/s meets the Care Standards Act 2000, Care Homes Regulations 2001 and the National Minimum Standards. The Registered Provider(s) must comply with the given timescales. No. Standard Regulation Requirement Timescale for action RECOMMENDATIONS These recommendations relate to National Minimum Standards and are seen as good practice for the Registered Provider/s to consider carrying out. No. 1 Refer to Standard OP7 Good Practice Recommendations The acting manager should ensure that as the new plans are put together, staff formally record their interaction/agreement with the resident or representative. I.e by that individual’s signature in the specific space within the plans. A report should be given to the manager each month after the visit by the responsible individual. The provider should consider providing administration support to the manager. 2 3 OP33 OP31 White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 22 Commission for Social Care Inspection West Midlands Office West Midlands Regional Contact Team 3rd Floor 77 Paradise Circus Queensway Birmingham, B1 2DT National Enquiry Line: Telephone: 0845 015 0120 or 0191 233 3323 Textphone: 0845 015 2255 or 0191 233 3588 Email: enquiries@csci.gsi.gov.uk Web: www.csci.org.uk © This report is copyright Commission for Social Care Inspection (CSCI) and may only be used in its entirety. Extracts may not be used or reproduced without the express permission of CSCI White Lodge Residential Home DS0000067278.V355919.R01.S.doc Version 5.2 Page 23 - Please note that this information is included on www.bestcarehome.co.uk under license from the regulator. Re-publishing this information is in breach of the terms of use of that website. Discrete codes and changes have been inserted throughout the textual data shown on the site that will provide incontrovertable proof of copying in the event this information is re-published on other websites. The policy of www.bestcarehome.co.uk is to use all legal avenues to pursue such offenders, including recovery of costs. You have been warned!